Provider Demographics
NPI:1134218415
Name:JONES, HENRY EDWARD JR (DDS)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:EDWARD
Last Name:JONES
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 W VALENCIA RD
Mailing Address - Street 2:STE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746
Mailing Address - Country:US
Mailing Address - Phone:520-746-1068
Mailing Address - Fax:520-573-1887
Practice Address - Street 1:1400 W VALENCIA RD
Practice Address - Street 2:STE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745
Practice Address - Country:US
Practice Address - Phone:520-746-1068
Practice Address - Fax:520-573-1887
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2854122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
828432OtherUNITED CONCORDIA GP#
980845OtherUNITED CONCORDIA GP#
AZAZ0471060OtherBCBS OF AZ
AZU95431Medicaid
54041OtherSAFEGUARD